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Worry
Worry refers to the thoughts, images and emotions of a negative nature in a repetitive - uncontrollable manner that results from a proactive cognitive risk analysis made to avoid or solve anticipated potential threats and their potential consequences.1 Worry is described as a response to a moderate challenge for when the subject has inadequate skills.2 Worry turns to be problematic if one has been excessively apprehensive more days than not for at least six months. Introduction Psychologically, worry is part of Perseverative Cognition (a collective term for continuous thinking about negative events in the past or in the future).3 As an emotion "worry" is experienced from anxiety or concern about a real or imagined issue, often personal issues such as health or finances, or external broader issues such as environmental pollution, social structure or technological change. It’s a natural response to anticipated future problems. Excessive worry is a primary diagnostic feature of generalized anxiety disorder. Most people experience short-lived periods of worry in their lives without incident; indeed, a mild amount of worrying have positive effects, if it prompts people to take precautions (e.g., fastening their seat belt or buying insurance) or avoid risky behaviors (e.g., angering dangerous animals, or binge drinking), but with excessive worrisome people they overestimate future dangers in their assessments and in its extremities tend to magnify the situation as a dead end which results stress. Overestimation happens because analysis resources are a combination of external locus of control, personal experience and belief fallacies. Chronically worried individuals are also more likely to lack confidence in their problem solving ability, perceive problems as threats, become easily frustrated when dealing with a problem, and are pessimistic about the outcome of problem-solving efforts.4 Seriously anxious people find it difficult to control their worry and typically experience these symptoms: Restlessness, Fatigue, Difficulty concentrating, Irritability, Muscle tension and Sleep disturbance. Theories Avoidance Model of Worry The Avoidance Model of Worry (AMW) theorizes that worry is a verbal linguistic, thought based activity, which arises as an attempt to inhibit vivid mental imagery and associated somatic and emotional activation.5This inhibition precludes the emotional processing of fear that is theoretically necessary for successful habituation and extinction of feared stimuli.6 Worry is reinforced as a coping technique due to the fact that most worries never actually occur, leaving the worrier with a feeling of having successfully controlled the feared situation, without the unpleasant sensations associated with exposure.7 Cognitive Model of Worry This model explains pathological worry to be an interaction between involuntary (bottom-up) processes, such as habitual biases in attention and interpretation favoring threat content, and voluntary (top-down) processes, such as attentional control. Emotional processing biases influence the probability of threat representations into the awareness as intruding negative or positive thoughts. At a pre-conscious level, these processes influence the competition among mental representations in which some correspond to the assertive power of worry with impaired cognitive process and others to the preventive power of worry with attentional control or exhaustive vigilance. The biases determine threatening degree and nature of worry content the worrier attempts to resolve the perceived threat and the redirection of anticipations, responses and coping in such situations.8 There are some who respond to mental representations in an uncertain or ambiguous state in regard to the stressful or upsetting event.9 In this state the worrier is held in a perpetual state of worry. This is because availability of an overwhelming number(maybe 2 or 3, depending upon the worry-prone individual) of possibilities of outcomes which can be generated, it puts the worrier in a threatening crisis and they focus their attentional control voluntarily on the potential negative outcomes, whereas others engage in a constructive problem solving manner and in a benign approach rather than to engage with heightened anticipation on the possible negative outcome.10 Philosophical perspectives Biblical word used in Hebrew describes worry (Hebrew: דָּאַג‎‎ daag) as a combined form of fear and sorrow. Bible takes a fortitude strengthening approach regarding worrying. Mathew 6:27,34 encourages: "And can any of you by worrying add a single hour to your span of life?... So do not worry about tomorrow, for tomorrow will bring worries of its own. Today’s trouble is enough for today." and pastoral epistles 2 Timothy 1:7 emboldens: " for God did not give us a spirit of cowardice, but rather a spirit of power and of love and of self-discipline." Similarly James 1:2-4 motivates to face trials of any kind with joy, because they produce endurance (strength and courage).11 Meher Baba stated that worry is caused by desires and can be overcome through detachment: "Worry is the product of feverish imagination working under the stimulus of desires ....(It) is a necessary resultant of attachment to the past or to the anticipated future, and it always persists in some form or other until the mind is completely detached from everything."12 Management Worry System is activated from exposure of a potential triggering event, traumatic experience or vulnerability, this brings worrisome thoughts and feelings which then exhibit physical stress reactions and active response to check and avoid worrisome behavior to ensure allostasis, but under the crisis this activity feeds back into the first worrisome thoughts and feelings, which generates and strengthens (locked in) the vicious worry cycle. Relaxation, risk assessment, worry exposure and behavior prevention have been proven effective in curbing the excessive worry that is the chief feature of generalized anxiety disorder (O’Leary, Brown, and Barlow 1992). Cognitive behavioral techniques hasn't branched out enough to address the problem holistically but it can control or diminish worry (Brown, Hertz, and Barlow 1992).